Individual
MICHAEL D STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
259 E ERIE ST FL 13, CHICAGO, IL 60611-3926
(312) 695-6800
(312) 695-2772
Mailing address
676 N. ST. CLAIR SUITE 1350, NORTHWESTERN MEDICAL FACULTY FOUNDATION, CHICAGO, IL 60611
(312) 695-5902
(312) 695-3018
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-098815
IL
207XX0801X
Orthopaedic Trauma Physician
36098815
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36098815
—
IL
01
—
L81088
MEDICARE
IL
Enumeration date
02/14/2006
Last updated
02/04/2020
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